Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In order to evaluate the presence of myocardial hypertrophy and/or abnormalities of postnatal cardiovascular adaptation, echocardiograms were performed on 34 infants of diabetic mothers. Based on cardiopulmonary assessment, the IDM were divided into three groups: Group I with congestive heart failure predominating: Group II with respiratory distress predominating: Group III asymptomatic. Hypertrophy of the interventricular septum and of the walls of left and right ventricles was frequently present in IDM: this change was most notable in association with clinical CHF. Six IDM, four of whom were found to have CHF, had additional echocardiographic signs of subaortic stenosis. All IDM had normal indices of left ventricular performance, despite the presence of CHE. In IDM with respiratory distress, the right ventricular pre-ejection period to ventricular ejection time ratio was elevated, suggesting an abnormality of the transitional pulmonary circulation. Poor maternal diabetes control and maternal systemic hypertension were closely correlated with evidence of myocardial hypertrophy in the infants.
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PMID:Echocardiographic abnormalities in infants of diabetic mothers. 15 51

The enzyme gamma-glutamyl transpeptidase is widely distributed throughout the body, notably kidney, seminal vesicles, pancreas, liver, spleen and brain. Being one of the enzymes of the gamma-glutamyl cycle, it is involved in aminoacid transport, catalysing a transpeptidation reaction between gamma-glutamyl peptides and most common amino acids. Methods of assay of the enzyme are based on its ability also to act on synthetic amides of glutamic acid; kinetic methods monitoring the release of p-nitroaniline from the substrate L-gamma-glutamyl p-nitroanilide are the most satisfactory. In diseases of the liver, the highest levels occur in association with cirrhosis, alcoholism, hepatic secondaries and cholestasis. As the enzyme is present in the endoplasmic reticulum of the hepatocyte, its activity is increased in situations leading to microsomal enzyme induction. Raised levels can also occur in pancreatitis, diabetes, myocardial infarction, congestive cardiac failure, chronic renal failure, cerebrovascular accidents, cerebral tumours and chronic obstructive pulmonary disease. Although the lack of specificity must be recognised, the estimation can be useful in the elucidation of some clearly defined problems arising during investigation of patients with suspected hepatic disease, especially where performed as part of a biochemical profile.
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PMID:Role of gamma-glutamyl transpeptidase activity in the diagnosis of hepatobiliary disease. 24 76

To evaluate the efficacy of coronary bypass surgery in reduction of sudden death, the prognosis of 286 similar patients with multivessel coronary stenosis was studied prospectively and the results of medical therapy (Group I, 114 patients) were compared with those of surgical therapy (Group II, 172 patients) after cardiac catheterization and coronary arteriography. During 39 months' evaluation of both groups, mortality from congestive heart failure and noncardiac causes did not differ (Group I, 14 percent; Group II, 8 percent) (P greater than 0.05). Sudden was evaluated in the remaining 217 patients (Group I, 96; Group II, 121 patients) who were matched for age (Group I, 52 years; Group II, 51 years); duration of overt coronary disease (Group I, 3.8 years; Group II, 4.0 years); angina pectoris (Group I, 83 percent; Group II, 95 percent); prior myocardial infarction (Group I, 77 percent; Group II, 74 percent); and congestive heart failure (Group I, 30 percent; Group II, 23 percent) (all P greater than 0.05). In addition, the prevalence of coronary risk factors was the same (P greater than 0.05) in both groups (hypertension, cigarette smoking, diabetes mellitus, lipid abnormalities and family history of coronary disease). Importantly, arteriography and catheterization established a similar extent and location of major coronary arterial stenoses and of ventricular dysfunction; two vessel disease (Group I, 32 percent; Group II, 33 percent) and three vessel disease (Group I, 68 percent; Group II, 67 percent); left ventricular end-diastolic pressure (Group I, 13; Group II, 14 mm Hg);cardiac index (Group I, 2.85; Group II, 2.91 liters/min per m2); and coronary collateral vessels (Group I, 58 percent; Group II, 61 percent) (all P greater than 0.05). Fifty-six percent of patients in Group II had multiple bypass grafts and a late patency rate (average 21 months) of 87 percent of one or more grafts. During subsequent prospective evaluation of over 3 years, bypass surgery provided greater symptomatic benefit of improved functional capacity (Group I, 12 percent; Group II, 69 percent) (P less than 0.05) and complete anginal relief (Group I, 30 percent; Group II, 60 percent) (P less than 0.05). Moreover, bypass surgery was associated with marked reduction in sudden death (Group I, 24 percent; Group II, 6 percent) (P less than 0.05). Thus, in patients with multivessel coronary disease carefully matched for clinical factors, hemodynamics, atherogenic precursors and coronary pathoanatomy, effective aortocoronary bypass surgery appeared to prolong survival by decreasing the incidence of sudden death, possibly by a decrease of unexpected fatal arrhythmias.
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PMID:Improved longevity due to reduction of sudden death by aortocoronary bypass in coronary atherosclerosis. 32 59

Based on 20 years of surveillance of the Framingham cohort relating subsequent cardiovascular events to prior evidence of diabetes, a twofold to threefold increased risk of clinical atherosclerotic disease was reported. The relative impact was greatest for intermittent claudication (IC) and congestive heart failure (CHF) and least for coronary heart disease (CHD), which was, nevertheless, on an absolute scale the chief sequela. The relative impact was substantially greater for women than for men. For each of the cardiovascular diseases (CVD), morbidity and mortality were higher for diabetic women than for nondiabetic men. After adjustment for other associated risk factors, the relative impact of diabetes on CHD, IC, or stroke incidence was the same for women as for men; for CVD death and CHF, it was greater for women. Cardiovascular mortality was actually about as great for diabetic women as for diabetic men.
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PMID:Diabetes and cardiovascular disease. The Framingham study. 43 Jul 98

This paper reemphasizes that xeromammographic changes in the skin, parenchyma, and vascular structures of the breast may be manifestations of a host of systemic diseases. Xeromammographic examples of such diseases as congestive heart failure, diabetes mellitus, collagen vascular diseases, and endocrine diseases are presented and discussed.
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PMID:The breast as a mirror of systemic diseases. 59 56

Groups of patients such as the elderly, the diabetic and women have been studied to evaluate the effectiveness of coronary revascularization. In this report 77 patients under age 40 years undergoing coronary revascularization were studied. There was a high prevalence rate of predisposing factors. Sixty-eight percent reported a family history of heart disease and 27 percent a history of diabetes; 57 percent were hypertensive, 43 percent were overweight, 91 percent smoked, 5 percent were diabetic and 16 percent had abnormal glucose tolerance curves. Sixty-four percent had hypercholesterolemia (cholesterol 250 mg/100 ml) and 56 percent hyperlipidemia. Forty-four percent had had a previous myocardial infarction; 95 percent had angina pectoris, 12 percent preinfarction angina and 9 percent congestive cardiac failure. There were no operative deaths. The incidence rate of perioperative myocardial infarction (new Q waves in the electrocardiogram) was 4 percent. The mean length of of follow-up was 26 months (range 6 months to 5 years). The late mortality rate was 4 percent. Eight percent had a late myocardial infarction. Overall graft patency was 85 percent. Sixty-seven percent of patients were free of angina, and 17 percent were in improved condition. Seventy-one percent returned to work, while 29 percent remained unemployed. This study shows that in young patients, coronary revascularization is associated with low mortality and morbidity rates and that, despite the wide prevalence of predisposing factors, the prognosis and graft patency rate of these patients are similar to those of other groups.
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PMID:Coronary revascularization under age 40 years. Risk factors and results of surgery. 62 35

Vasodilators acutely reduce afterload and improve hemodynamics in congestive heart failure. Intravenous nitroprusside reduces left ventricular filling pressure and increases cardiac output while modestly reducing blood pressure and not changing heart rate in patients with heart failure in whom this response is characteristic. Comparably reduced blood pressure during nitroprusside infusion in normal subjects or hypertensive patients without failure results in a decrease in cardiac output and tachycardia. Long-acting vasodilators are also effective in patients with congestive heart failure. Nitrates, predominant venodilators, decrease left ventricular filling pressure as much as nitroprusside does, but increase cardiac output less. Hydralazine, an arterial dilator, increases cardiac output similarly to nitroprusside but decreases filling pressure less. Combining hydralazine with nitrates results in hemodynamic effects almost identical to those of nitroprusside. The quinazoline derivatives, trimazosin and prazosin, are also effective vasodilators, which act on both arteries and veins in patients with congestive heart failure. The hemodynamic response to vasodilators is influenced by the underlying hemodynamic status, as the change in cardiac output is directly related to base line ventricular filling pressure as well as systemic vascular resistance, and inversely related to the base line cardiac output. Response to vasodilators does not appear to be altered by age, diabetes, acute myocardial infarction or the cause of congestive myocardiopathy.
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PMID:Hemodynamic responsiveness to short- and long-acting vasodilators in left ventricular failure. 68 86

Most family physicians provide regular care in the community hospital setting. The North American literature is quite deficient in documenting this aspect of family practice. The purpose of this paper is to present the content of problems cared for in a small community hospital. The study population consisted of all inpatients care for principally by the author during the first year in practice. The hospital is a 100-bed facility in a representative midwestern community of 15,000. Data analyzed included age, sex, discharge diagnoses, and outcome. Diagnoses were coded and organized according to the ICHPPC code. During the one-year study period, 509 hospital problems were cared for. Primary responsibility for 235 hospitalizations was assumed, for an average of 19.6 patients hospitalized per month. The age/sex profile, when corrected for newborns and obstetric patients, showed peaks in the 75+ age category for both sexes. By major ICHPPC category, circulatory system diseases ranked first and respiratory diseases ranked second. Most frequent specific diagnoses were: (1) newborn care, (2) vaginal delivery, (3) congestive heart failure, (4) diabetes, and (5) chronic lung disease. There were eight deaths of 3.4 percent of the hospitalizations.
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PMID:Hospital problems cared for by one family physician. 69 May 87

Serial study of 72-lead precordial ST-maps, SGOT, and SLDH was done in 30 cases of acute myocardial infarction. Infarct size was estimated by sum of ST elevation in all leads (sigma ST), number of sites showing ST elevation (NST), peak SGOT, and peak SLDH levels, and correlated with each other and with clinical features and hospital course. sigma ST correlated well with NST (r=0.92), but the correlations of sigma ST with SGOT (r=0.99) and SLDH (r=3.84) were better than those of NST with SGOT (r=0.22) and SLDH (r=0.53). There were close agreements between sigma ST and peak SGOT and peak SLDH except in the cases of non-transmural infarction, in whom smaller sigma ST suggesting small infract occurred with higher enzyme peaks indicating moderate or large infarct. Longer duration of chest pain, larger number of associated conditions (e.g. angina, hypertension, diabetes), complications (e.g. congestive heart failure, shock, arrhythmias) and mortality were associated with larger infarcts.
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PMID:Precordial ST-segment changes and serum enzyme levels in acute myocardial infarction. 73 32

Obesity leads to several complications that affect many body systems. This paper focuses mainly on the cardiovascular complications, which include coronary heart disease, cerebrovascular disease and stroke, and congestive heart failure; the last may be secondary not only to advanced coronary atherosclerosis, but also to other pathogenetic factors. The increased frequency of coronary heart disease in the obese is largely attributable to the commonly associated hypertension, diabetes mellitus and lipoprotein abnormalities, rather than the adiposity. The lipoprotein disorders that have a role in atherogenesis are decreased plasma concentrations of high-density lipoproteins and elevated plasma concentrations of low-density lipoproteins. Abnormalities in cholesterol metabolism are responsible for the increased frequency of cholelithiasis in obese persons. The factors that mediate the development of cardiovascular and gallbladder complications are correctable by an appropriate program of meal planning and physical activity.
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PMID:Medical complications of obesity. 73 18


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